Big Pharma Conspiracy Debunked

January 12, 2016

There are many conspiracy theories about huge, multinational corporations. One of the most common accusations is that drug companies routinely and actively hide evidence that their drugs are ineffective or even dangerous.

This idea is central to the claims made by anti-vaccination groups, who believe that an international cabal of evil and unethical doctors and medical experts are aware that childhood vaccines are dangerous to children but hide that information from the public and refuse to acknowledge it to protect drug companies' enormous profits. This is part of the reason they are so zealous: they truly think that doctors are so greedy and callous that they help cover up dead and brain-damaged children to pad their bank accounts. (I have several friends in the medical profession who find that deeply insulting.)

A corollary to this claim is that money from drug companies is so powerful that not only are studies that might reveal a drug's ineffectiveness not done because they refuse to fund them, but that scientists and researchers are afraid to even conduct research that might challenge Big Pharma's bottom line. After all, the huge drug companies keep track of which researcher are looking into which drugs, and scientists fear offending the companies who pay for their research: Publishing a study calling into question the safety or efficacy of a popular drug--assuming any medical journal would even be brave enough to accept and print it--would be career suicide, according to the conspiracy folk.

There is certainly a grain of truth to this conspiracy theory--it's undeniable that industries can and do sometimes pressure scientists to publish research favorable to them and bury or downplay unfavorable studies. This has happened many times, including tobacco companies' research into the addictiveness of nicotine and more recently General Motors hiding studies of safety flaws in their vehicles.

But not all major industries are alike, and the fact is that peer-reviewed studies casting doubt on the efficacy of popular drugs, therapies, and devices are routinely published in some of the world's most prestigious journals.

For example last year the British Medical Journal published a research paper titled "Efficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta-analysis of randomised placebo controlled trials." Its conclusion: "Paracetamol is ineffective in the treatment of low back pain and provides minimal short term benefit for people with osteoarthritis. These results support the reconsideration of recommendations to use paracetamol for patients with low back pain and osteoarthritis of the hip or knee in clinical practice guidelines."

Recently researchers published a study in the journal Respirology that examined the same drug: The study, "Randomized controlled trial of the effect of regular paracetamol on influenza infection," was a randomized, double-blind, placebo-controlled trial of adults with influenza-like illness and positive influenza rapid antigen test. The conclusion: "Regular paracetamol had no effect on viral shedding, temperature or clinical symptoms in patients with PCR-confirmed influenza. There remains an insufficient evidence base for paracetamol use in influenza infection." There are many other similar studies easily found in a quick online search.

For those who don't know, paracetamol is sold under the brand Tylenol, which is manufactured and marketed by McNeil Consumer Healthcare, a subsidiary of Johnson & Johnson, which in 2014 had revenues of nearly $75 billion.

In other words these studies (and others) found no evidence that taking Tylenol will help if you have the flu, and no evidence that it helps lower back pain. These studies were widely published and made national headlines along the explicit lines of "Tylenol Doesn't Work" and "Everything You Thought About Tylenol Is Wrong."

So what happened? Did these researchers refuse million-dollar bribes by Johnson & Johnson to scuttle the studies? Did the journal editors refuse million-dollar bribes by Johnson & Johnson to refuse to accept the studies or reject them in peer-review? Did the hundreds of mainstream journalists refuse million-dollar bribes by Johnson & Johnson to spike the story? None of the above; the simple and correct answer is that conspiracy theorists are wrong.

It's akin to the claim that Big Oil has suppressed engines that run on water or air, or that drug companies have a cure for cancer but are refusing to market it because people dying of cancer is so profitable. No one denies that some in the pharmaceutical industry-like those in many highly profitable industries-has in many cases acted against the public good. As Dr. Steven Novella has noted many times including in his Science-Based Medicine blog, "There is much to criticize in how the pharmaceutical industry has tried to subvert medical research to their advantage. This is why they need to be carefully monitored and regulated."

However satisfying it may be to demonize an entire industry, we must not be too quick to give the Devil more than his due. The image of Big Pharma as shadowy, corrupt entities spending vast resources to fool the public and do evil is surely unearned. Many people are alive today because drug companies developed life-saving medications and treatments, and many drug companies have offered deeply discounted prices on basic drugs for the masses in South America, Africa, India, and elsewhere.

As a practical matter drug companies would have a very difficult time actually preventing research from being done or negative studies published the way that, for example, the National Rifle Association has for decades intentionally prevented research into gun-related homicide trends. Science is self-correcting, and sooner or later the truth will come out about the safety and efficacy of a given drug or treatment. The vested interest in profits that makes Big Pharma such a notorious and easy target also encourages them to take steps to assure health and safety. It's bad for business to sell drugs that harm your customers.

These studies are clear-cut, published and public examples of exactly what anti-Big Pharma conspiracy theorists claim doesn't happen. It doesn't matter, of course, since the conspiracy echo chamber isn't interested in explaining inconvenient facts. Despite years of false accusations about me (being a shill for Big Pharma, for example), I have no dog in the fight and no allegiance to the drug industry. However the often-heard claim that drug companies overtly prevent studies unfavorable to their products from being published is, at best, greatly exaggerated. Johnson & Johnson's billions apparently can't prevent independent researchers from publishing studies questioning the effectiveness of their best-selling OTC pain reliever (nor, for that matter, can they prevent journalists from covering the results of the studies). The evidence is right there in plain view for those who wish to look.

Comments:

#1 David Colquhoun (Guest) on Tuesday January 12, 2016 at 2:19pm

I think that piece is a bit too complacent. Remember Tamiflu.to name but one.

Actually I’m not sure Tamiflu is a good example; its effectiveness has also been publicly challenged in peer-reviewed medical journals. See, for example, “Neuraminidase inhibitors for preventing and treating influenza in adults and children,” in Cochrane Database of Systematic Reviews, by Jefferson et al.

#3 David Colquhoun (Guest) on Wednesday January 13, 2016 at 1:52am

Yes, it was challenged *after* the UK taxpayers had spent half a billion pounds on it, because of misleading information from Roche.

If you ignore things like that, if makes CFI look like just another lobby group, and that would be very sad.

#4 Guy Chapman (Guest) on Wednesday January 13, 2016 at 8:01am

It is by now I think a truism to say that problems with medicine validate quackery in exactly the same way that plane crashes validate magic carpets.

#5 David Colquhoun (Guest) on Wednesday January 13, 2016 at 8:12am

@Guy Chapman
That’s absolutely right, of course. The question of big pharma is entirely different from quackery. Nonetheless, the same standards of evidence and of transparency apply to both. And sadly both fail. Ben Goldacre pointed out a long time ago that both industries use similar techniques to improve sales. It’s crucial that skeptics apply the same standards to both industries.

I quite agree that there have been cases where specific drug companies (not “Big Pharma” as a homogenous whole) have sought to bury or hide studies that are unflattering to some products they market; that is the “grain of truth” referred to in the piece. That is, however, not what conspiracy theorists refer to.

#7 Mario (Guest) on Wednesday January 13, 2016 at 2:09pm

At most, your piece demonstrates that the craziest theories of the most paranoid conspiracy theorists fail to pan out across the pharma industry. From that, you generalize that the pharma companies are, by and large, honest operations. What?? You’re basing a conclusion on (pick one) negative or nonexistent info. You’re doing both, really.

We know Donald Trump isn’t a mad scientist plotting to destroy the world with killer robots. Therefore, he must be an okay sort of guy?

Your piece reminds me of an all-time classic Rolling Stone essay in which the author claims (falsely) that no one has any idea when rock started. Therefore, he continues, it started in 1954. In other words, we don’t know when it started, so it must have been 1954.

Of course, if we’re playing pick-a-date-any-date, then rock may as well have started in 1844. Or before recorded time. Etc. If no one knows, no one knows.

We can’t base a broad conclusion on what we DON’T know about something. For instance, you have my word that I’m not a purple blob from Pluto. But, based on that knowledge, what can you deduce about me? (That I’m a blue blob from Pluto? Bingo!)

Okay, so we know that the pharma industry isn’t deliberately poisoning people or hiding cadavers in some secret bunker to keep a lid on the truth about Aspergum. Does that mean the industry is on the up and up overall? It proves nothing of the kind.

#11 Old Rockin' Dave (Guest) on Friday January 15, 2016 at 10:38am

Conspiracy claims flourish because of people who lack knowledge and/or common sense.
I can’t imagine any serious researcher taking money from “Big Pharma” to suppress the “secret cure for cancer”. Oncologists and their families and friends develop cancer and die from it just like anyone else. I helped to treat the brother of a heavyweight oncology researcher, who died from his cancer. If this famous figure had a “secret cure” isn’t it overwhelmingly likely that he would have used it?
In addition, what bribe could even the largest drug company offer that would be superior to the honors, fame, awards, prizes, research grants, and more that would shower onto the cure-finder?
Just tell anyone who believes that to take a look at the Salk Institute, and he got that as a consequence of a vaccine for a disease that was even then far less prevalent than cancer.

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Benjamin Radford, M.Ed., is a scientific paranormal investigator, a research fellow at the Committee for Skeptical Inquiry, deputy editor of the Skeptical Inquirer, and author, co-author, contributor, or editor of twenty books and over a thousand articles on skepticism, critical thinking, and science literacy. His newest book is Bad Clowns; his next, Investigating Ghosts: The Scientific Search for Spirits, will be out in Fall 2017.